<?php

require 'header.php';

?>

    <div class="middle">
		<div class="simple-container-left" id="page:main-container">
			<div class="container" id="page:container">
				<div class="main">
					<div class="content-container">
						<div class="content" id="content">
							<div class="content-header">
								<table class="grid-header" cellspacing="0">
									<tbody>
										<tr>
											<td style=""><h3 class="icon-head head-customer">New Collateral</h3></td>
											<td class="a-right">
												<button type="button" class="scalable back" onclick="setLocation('collateral.php')" style=""><span>Back</span></button>
												<button type="button" class="scalable" onclick="setLocation(window.location.href)" style=""><span>Reset</span></button>
												<button type="button" class="scalable save" onclick="editForm.submit();" style=""><span>Save Collateral</span></button>
											</td>
										</tr>
									</tbody>
								</table>
							</div>
							<div id="messages"></div>
							
							<form name="form1" id="form1" action="/" method="post">
							<div class="entry-edit">
								<h4 class="icon-head head-edit-form fieldset-legend">Collateral Information</h4>
								<fieldset>												
									<table width="100%" cellspacing="0">
										<tbody>
											<tr>
												<td>
													<table width="100%" cellspacing="5">
														<tbody>
															<tr>
																<td>ID Number <span class="required">*</span></td>
																<td><em>Autogenerated</em></td>
															</tr>
															<tr>
																<td>Borrower ID <span class="required">*</span></td>
																<td><input name="borrower_id" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>
															<tr>
																<td>Item Description <span class="required">*</span></td>
																<td><textarea name="item_description" cols="20" rows="5"></textarea></td>
															</tr>
															<tr>
																<td>Manufacturer</td>
																<td><input name="manufacturer" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>
															<tr>
																<td>Model# <span class="required">*</span></td>
																<td><input name="model_no" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>
															<tr>
																<td>Serial# <span class="required">*</span></td>
																<td><input name="serial_no" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>
															<tr>
																<td>Date of Purchase <span class="required">*</span></td>
																<td><input name="purchase_date" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>					
															<tr>
																<td>Collateral Status <span class="required">*</span></td>
																<td>
																	<select name="collateral_status" class="required-entry required-entry select" type="select">
																	<option value="1">Borrower in Possession</option>
																	<option value="2">Borrower Not In Posession</option>
																	<option value="1">Repossessed</option>
																	<option value="2">For Sale</option>
                                                                                                                                        <option value="2">Sold</option>
																	</select>
																</td>
															</tr>		
															<tr>
																<td>For Sale Price <span class="required">*</span></td>
																<td><input name="for_sale_price" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>
															<tr>
																<td>Sold Price </td>
																<td><input name="sold_price" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>
															<tr>
																<td>Amount returned to borrower <span class="required">*</span></td>
																<td><input name="amount_returned" value="" class="required-entry required-entry input-text" type="text"></td>
															</tr>
															<tr>
																<td>Amount kept for repayment <span class="required">*</span></td>
																<td>
																	<input name="amount_kept" value="" class="required-entry required-entry input-text" type="text">
																</td>
															</tr>
														</tbody>
													</table>
									
												</td>
												<td>
												
													<table width="100%" cellspacing="5">
														<tbody>
															<tr>
																<td align="center"><img src="img/collateral.jpg" width="200" height="200" /></td>
															</tr>
															<tr>
																<td align="center"><input name="photo" value="" class="required-entry required-entry input-text" type="file"></td>
															</tr>
														</tbody>
													</table>
											
												</td>
											</tr>
										</tbody>
									</table>
								
								</fieldset>
								
								
								<div align="center">
									<button type="button" class="scalable back" onclick="setLocation('collateral.php')" style=""><span>Back</span></button>
									<button type="button" class="scalable" onclick="setLocation(window.location.href)" style=""><span>Reset</span></button>
									<button type="button" class="scalable save" onclick="editForm.submit();" style=""><span>Save Collateral</span></button>
								</div>

							</div>
							
							
							</form>
						</div>
					</div>
					
					<div class="section-menu" id="page:left">
						<h3>Profile Center</h3>
						<ul id="customer_info_tabs" class="tabs">
							<li>
						        <a href="collateral.php" title="Contact Information" class="tab-item-link">
					            <span>Contact Information</span>
						        </a>        
						    </li>
						    <li>
						        <a href="collateral.php" title="Collateral Items" class="tab-item-link active">
					            <span>Collateral Items</span>
						        </a>		        
						    </li>
					            <li>
						        <a href="" title="Employee Information" class="tab-item-link">
					            <span>Employee Information</span>
						        </a>        
						    </li>
						</ul>
						<div class="bottom"></div>
					</div>
              	</div>
			</div>
		</div>
	</div>

<?php

require 'footer.php';

?>